30-D - Designation Of Treasurer Form
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230-D
R.C. 3517.10
Designation of Treasurer
Reset Form
Prescribed by Secretary of State 07/05
All Committees
Full Name of Committee
Street Address
Telephone Number
e-mail Address
City
State
Zip Code
FAX Number
OH
Full Name of Treasurer
Street Address
Telephone Number
e-mail Address
City
State
Zip Code
FAX Number
OH
Full Name of Deputy Treasurer (if any)
Street Address
Telephone Number
e-mail Address
City
State
Zip Code
FAX Number
OH
Candidate’s Campaign Committees Only
Full Name of Candidate
Party Affiliation/Independent/Non-Partisan
Street Address
Office Sought
Subdivision/District
City
State
Zip Code
Election Year
OH
Signature of Candidate
Date
Political Action Committees Only
Is the PAC sponsored by a labor
If Yes, name the sponsor
Acronym, if any
organization or corporation?
l No
l Yes.
PAC Registration Number
Authorized Signature
Date
List any affiliated PACs
Political Parties, Political Contributing Entities,
or Legislative Campaign Funds Only
l
l
Authorized Signature
Date
Ballot Issue PAC?
Yes
No
_________________________________________________________________________________
____________________________
Signature of Treasurer
Date
Reason(s) for filing this form:
l Original Designation of Treasurer/Acknowledgement of Appointment
l Change of Treasurer/Acknowledgement of Appointment
l Designation or change of Deputy Treasurer
l Change of Address for
___________________________________________________________________
l Change of Committee name. The previous name was: ________________________________________________________
l Change of Filing Location. The previous location was: _________________________________________________________
The new location is: _______________________________________________________________
l Change of Office Sought from _____________________________ to ________________________________________
l Other. Please explain: ____________________________________________________________________________________
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Parent category: Legal